Individual
ROBERT E BROUILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5440 W FRANKLIN RD, STE 100, BOISE, ID 83705-1079
(208) 422-1555
Mailing address
5440 W FRANKLIN RD, STE 100, BOISE, ID 83705-1079
(208) 422-1555
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT-2323
ID
Other
Enumeration date
01/25/2008
Last updated
09/05/2011
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